| NPI | 1821444563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME146087) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 297757) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2025-08-28 |